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Fig. 3. —Graph shows estimated probability of hepatic malignancy using presence or absence of arterial phase enhancement and of venous phase washout and serum -fetoprotein level. With baseline patient age of 55 years, index lesion size of 4.4 cm, and three lesions, probability of malignancy exceeds 60% regardless of -fetoprotein level if arterial phase enhancement and either venous or delayed phase washout are present (); it rises to more than 80% if -fetoprotein value is greater than 10 ng/mL. In patients with a normal -fetoprotein level (<20 ng/mL), probability of malignancy is less than 10% if both arterial phase enhancement and venous phase washout are absent (). In average patient with either arterial enhancement and no venous washout () or no arterial enhancement and venous washout (), but not both, contribution of -fetoprotein level to estimation of malignancy is increased.